Precise longitudinal tracking of microscopic structures in melanocytic nevi using reflectance confocal microscopy a feasibility study

Alon Scope, Limor Selinger, Margaret Oliviero, Francesca Farnetani, Elvira Moscarella, Caterina Longo, Harold S. Rabinovitz, Giovanni Pellacani

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

IMPORTANCE: Reflectance confocal microscopy (RCM), a cellular-level, in vivo imaging technique, may be potentially used for monitoring melanocytic neoplasms for microscopic stability vs changes over time. OBJECTIVE: To test feasibility of using RCM to track specific microscopic structures within nevi over 1 year. DESIGN, SETTING, AND PARTICIPANTS: This was an observational study, a review of prospectively acquired RCM images, performed at a tertiary academic medical center. Seventeen patients were enrolled from adult patients presenting to pigmented lesion clinic; from each participant, 3 confirmed benign nevi were randomly selected from the upper and lower back and from the lower extremity. EXPOSURES Nevi underwent standardized RCM imaging at baseline and after 1 year. MAIN OUTCOMES AND MEASURES: We tested interobserver reproducibility in recognition of tissue anchors, RCM structures that can be identified at 2 time points. We used 2 tests to measure concordance between independent readers: (1) In the multiple choice matching test (n = 43 nevi), readers were shown a tissue anchor in a baseline RCM image (≤ 1 × 1-mm field-of-view) and asked to identify the same structure in 1 of 4 equally sized RCM images obtained from the same nevus at follow-up. (2) In the annotation test (n = 29 nevi), readers were shown a tissue anchor in a follow-up RCM image (≤1 × 1-mm field-of-view) and asked to annotate the corresponding location of this structure in the baseline RCM mosaic image (≤ 5 × 5-mm field-of-view) from the same nevus; good agreement was defined as annotations deviant by less than 10% of the mosaic's width. RESULTS: In total, 17 patients (mean age, 45 years [range, 28-70 years]; 10 [59%] were women) contributed a total of 51 nevi, of which 44 nevi (86%) were used for the study. Images from 7 nevi (14%) were suboptimal in quality. Tissue anchors were identified at both time points in all 44 nevi. Selected tissue anchors were located at a mean depth of 54.3 μm; the most commonly selected anchors (37 of 44 images [84.1%]) were dermal papillae. In the multiple choice matching test, compared with a reference reader, 2 readers correctly matched baseline to follow-up tissue anchors in 40 of 43 nevi (93%; P

Original languageEnglish
Pages (from-to)299-304
Number of pages6
JournalJAMA Dermatology
Volume152
Issue number3
DOIs
Publication statusPublished - Mar 1 2016

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Pigmented Nevus
Nevus
Feasibility Studies
Confocal Microscopy
Observational Studies
Lower Extremity

ASJC Scopus subject areas

  • Dermatology

Cite this

Precise longitudinal tracking of microscopic structures in melanocytic nevi using reflectance confocal microscopy a feasibility study. / Scope, Alon; Selinger, Limor; Oliviero, Margaret; Farnetani, Francesca; Moscarella, Elvira; Longo, Caterina; Rabinovitz, Harold S.; Pellacani, Giovanni.

In: JAMA Dermatology, Vol. 152, No. 3, 01.03.2016, p. 299-304.

Research output: Contribution to journalArticle

Scope, A, Selinger, L, Oliviero, M, Farnetani, F, Moscarella, E, Longo, C, Rabinovitz, HS & Pellacani, G 2016, 'Precise longitudinal tracking of microscopic structures in melanocytic nevi using reflectance confocal microscopy a feasibility study', JAMA Dermatology, vol. 152, no. 3, pp. 299-304. https://doi.org/10.1001/jamadermatol.2015.4993
Scope, Alon ; Selinger, Limor ; Oliviero, Margaret ; Farnetani, Francesca ; Moscarella, Elvira ; Longo, Caterina ; Rabinovitz, Harold S. ; Pellacani, Giovanni. / Precise longitudinal tracking of microscopic structures in melanocytic nevi using reflectance confocal microscopy a feasibility study. In: JAMA Dermatology. 2016 ; Vol. 152, No. 3. pp. 299-304.
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abstract = "IMPORTANCE: Reflectance confocal microscopy (RCM), a cellular-level, in vivo imaging technique, may be potentially used for monitoring melanocytic neoplasms for microscopic stability vs changes over time. OBJECTIVE: To test feasibility of using RCM to track specific microscopic structures within nevi over 1 year. DESIGN, SETTING, AND PARTICIPANTS: This was an observational study, a review of prospectively acquired RCM images, performed at a tertiary academic medical center. Seventeen patients were enrolled from adult patients presenting to pigmented lesion clinic; from each participant, 3 confirmed benign nevi were randomly selected from the upper and lower back and from the lower extremity. EXPOSURES Nevi underwent standardized RCM imaging at baseline and after 1 year. MAIN OUTCOMES AND MEASURES: We tested interobserver reproducibility in recognition of tissue anchors, RCM structures that can be identified at 2 time points. We used 2 tests to measure concordance between independent readers: (1) In the multiple choice matching test (n = 43 nevi), readers were shown a tissue anchor in a baseline RCM image (≤ 1 × 1-mm field-of-view) and asked to identify the same structure in 1 of 4 equally sized RCM images obtained from the same nevus at follow-up. (2) In the annotation test (n = 29 nevi), readers were shown a tissue anchor in a follow-up RCM image (≤1 × 1-mm field-of-view) and asked to annotate the corresponding location of this structure in the baseline RCM mosaic image (≤ 5 × 5-mm field-of-view) from the same nevus; good agreement was defined as annotations deviant by less than 10{\%} of the mosaic's width. RESULTS: In total, 17 patients (mean age, 45 years [range, 28-70 years]; 10 [59{\%}] were women) contributed a total of 51 nevi, of which 44 nevi (86{\%}) were used for the study. Images from 7 nevi (14{\%}) were suboptimal in quality. Tissue anchors were identified at both time points in all 44 nevi. Selected tissue anchors were located at a mean depth of 54.3 μm; the most commonly selected anchors (37 of 44 images [84.1{\%}]) were dermal papillae. In the multiple choice matching test, compared with a reference reader, 2 readers correctly matched baseline to follow-up tissue anchors in 40 of 43 nevi (93{\%}; P",
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N2 - IMPORTANCE: Reflectance confocal microscopy (RCM), a cellular-level, in vivo imaging technique, may be potentially used for monitoring melanocytic neoplasms for microscopic stability vs changes over time. OBJECTIVE: To test feasibility of using RCM to track specific microscopic structures within nevi over 1 year. DESIGN, SETTING, AND PARTICIPANTS: This was an observational study, a review of prospectively acquired RCM images, performed at a tertiary academic medical center. Seventeen patients were enrolled from adult patients presenting to pigmented lesion clinic; from each participant, 3 confirmed benign nevi were randomly selected from the upper and lower back and from the lower extremity. EXPOSURES Nevi underwent standardized RCM imaging at baseline and after 1 year. MAIN OUTCOMES AND MEASURES: We tested interobserver reproducibility in recognition of tissue anchors, RCM structures that can be identified at 2 time points. We used 2 tests to measure concordance between independent readers: (1) In the multiple choice matching test (n = 43 nevi), readers were shown a tissue anchor in a baseline RCM image (≤ 1 × 1-mm field-of-view) and asked to identify the same structure in 1 of 4 equally sized RCM images obtained from the same nevus at follow-up. (2) In the annotation test (n = 29 nevi), readers were shown a tissue anchor in a follow-up RCM image (≤1 × 1-mm field-of-view) and asked to annotate the corresponding location of this structure in the baseline RCM mosaic image (≤ 5 × 5-mm field-of-view) from the same nevus; good agreement was defined as annotations deviant by less than 10% of the mosaic's width. RESULTS: In total, 17 patients (mean age, 45 years [range, 28-70 years]; 10 [59%] were women) contributed a total of 51 nevi, of which 44 nevi (86%) were used for the study. Images from 7 nevi (14%) were suboptimal in quality. Tissue anchors were identified at both time points in all 44 nevi. Selected tissue anchors were located at a mean depth of 54.3 μm; the most commonly selected anchors (37 of 44 images [84.1%]) were dermal papillae. In the multiple choice matching test, compared with a reference reader, 2 readers correctly matched baseline to follow-up tissue anchors in 40 of 43 nevi (93%; P

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